So, Elizabeth. She has had CKD-kidney disease-since March 2024. She has spent two years being mostly hand fed, going through few times of eating without assistance. She has had to be fed five times a day at 50ml of canned food at a time-or less if she is eating enough during the day. Her weight was down to almost 11lbs this fall, and then we got it up to 12lbs in order for her to maintain a level that leaves room for any future weight loss before we must be aggressive with hand feeding. (We need to prevent fat and muscle loss and muscle wasting which can happen with CKD.) For more on CKD, check out the comprehensive site "Tanya's Comprehensive Guide to Feline CKD" blog guide.
We use Hill’s KD canned because it is very easy to syringe up in a 10ml syringe and then to gently feed her. It takes about ten minutes. You cannot rush pushing food into their mouths. They can’t choke or inhale. Too much food and they spit it out. When she developed gastro issues in 2025, we had to feed her Hills’ ID which is not as easy to syringe up. But too much ID and her CKD increased; too much KD and her gastro issues increased. So, late in 2025, we began to mix almost half and half KD and ID canned food in one Tupperware dish, then spend a day or two feeding her from it (how quickly it goes depends on how much and how often we need to feed her via syringe.) Some days I try to do 2/3 ID and 1/3 KD; then 2/3 KD and 1/3 ID; then half and half or something akin to it.
She receives a ¼ Mirtazapine pill once a week. When her gastro system is doing well, she responds and will eat enough for a few days on her own with little hand feeding from us. But we do feed her 3 times a day at 30ml to 40ml per feeding depending on her needs. She often eats overnight which is a good sign. What is not a good sign is when she does not eat overnight or the Mirtazapine does not respond well and she barely eats despite it.
She has gone through these bouts of not feeling well. She has had bouts of diarrhea since the fall since she had surgery (more on that with another post.) Since she does not eat enough on her own, I have been since the fall, giving her daily by mouth with a syringe, a packet of Forta Flora mixed with 2ml of water or rice water (more on that in a moment) which she receives in the afternoon. She receives it in the afternoon because she is on an antibiotic and stomach supplements (antacids, fiber) tend to interrupt the absorption of antibiotics. That seems to help her. Rice water-1/2 cup of rice and three cups of water boiled until the rice is cooked but just cooked and the rice is not left to soak up the water; I scoop out the rice with a slotted spoon, put that into a container and freeze it, drain the water into a plastic container, and I should have enough for a week; any more than that and I put it into a container and into the freezer-works fast and is easy to make. (It can spoil so that is why I make sure I have enough for a week and put the rest in the freezer.) I give her 6 to 10ml of rice water twice a day depending on if she has diarrhea or how much she has (is it soft, liquid, more than once a day, etc.) If her bowel movements are solid, then I can skip it for a few days. But I have to monitor it closely so that it does not return too severely. (Diarrhea is uncomfortable, causes a loss of fluid and in the fluid a loss of electrolytes which makes the body feel run down and then that depletion of sodium [which regulates the body] causes more diarrhea [and vomiting if a cat or human is vomiting] and can lead to other gastro issues like stomach acid, ulcers, bleeding in the lower GI, etc.)
Why does she have gastro issues? She has IBD, at times pancreatitis, a thickened GI tract, and some liver issues. This means she has inflammation. But because she has CKD, she really should not have steroids. And she recently developed a minor heart issue so I do not want to risk her heart health by giving steroids. Yes, her gastro system would likely improve with steroids but then the rest of her would likely severely fail-her kidneys would tank (we saw that in December 2024 with Roxanne-more on her later; and we know that heart disease cats cannot have steroids due to the risk of CHF, and once CHF kicks in, the race is on to stop the heart from failing.)
I can tell when she is not feeling well by how she looks or appears to be uncomfortable, and does not eat. She is on medication to help her. She has taken Veraflox antibiotic for two months this past November 2025 into January 2026 but it worsened the diarrhea. It can cause gastro upset with prolonged use (we did not see that in Jimmy when he was on it for a month.) She has been off of it now for three weeks and her diarrhea cleared almost immediately. Typically, it’s given for 14 days on and then off but the vet wanted to use it longer to help her organs be less inflamed and infected. It can lead to higher levels of glucose, liver values AST, ALP, ALT (some of which we saw in her bloodwork and Jimmy’s blood work), as well as an elevated white count (not sure why.) Additionally, she is on Metronidazole which we hope is helping. Also, she had been on Visbiome probiotic-the capsule was opened and the powder was added to water and given by mouth since she was not eating. But that also increased diarrhea; it too can cause gastro upset. When ceased, the diarrhea lessened. Her ultrasounds however, do not show improvement regardless of antibiotics or fiber.
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| Lizzie |
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